28 January 2016

Dr Minh Alexander

Wellington House
133-155 Waterloo Road
London SE1 8UG
T: 020 3747 0000
E: enquiries@monitor.gov.uk
W: www.monitor.gov.uk

By email
minhalexander@aol.com

Dear Dr Alexander,

I refer to your email of 30 December 2015, which you wrote in response to my letter dated
23 December 2015.

You expressed views on a number of matters relating to Monitors Interim Executive Pool
and the fit and proper persons requirement in its licence. You asked a number of specific
questions which are set out below with our responses.
1) What references and case studies did Monitor rely upon when it admitted Ms
Vasco-Knight to its interim pool? Please also advise if East Lancashire Hospitals
NHS Trust or any other public body provided a reference.
As with all candidates in Monitors Interim Executive candidate pool, Paula Vasco-Knight had
to submit the names of four business referees, and details of two case studies which
demonstrate her work capabilities which the referees could validate. The business referees
put forward, from whom references were sought and obtained, all held senior roles in the
NHS Trusts that Paula Vasco-Knight had recently worked for, including East Lancashire
Hospitals NHS Trust.
2) What are Monitors written standards and protocol for admitting managers to its
interim pool?
Candidates are admitted to Monitors Interim Executive candidate pool on the basis of the
references and case studies together with any relevant information held by Monitor
demonstrating that they may have the potential to be suitable to perform interim executive
roles at NHS Foundation Trusts (NHS FTs).

Admission to the interim pool is not a form of preselection for roles at NHS FTs. It is a
mechanism for Monitor to gather information on potential candidates for interim executive
roles, to be provided to NHS FTs in need of interim executive support, where appropriate. As
explained in our letter of 23 December 2015, it is a matter for NHS FTs in exercising their
statutory and other responsibilities in relation to executive roles to assess whether a
candidate is the appropriate appointment for any particular vacancy. It is a matter for NHS
FTs also to gather all necessary additional information needed to discharge such
responsibilities, including that needed to discharge the CQC fit and proper persons test.
3) In the light of the above, will Monitor please ensure that its narrow definition of Fit &
Proper Persons is broadened, so that it mirrors CQCs definition under Regulation 5?
In putting forward this question you have referred in support to aspects of the Report of the
Mid Staffordshire NHS Foundation Trust Public Inquiry: executive summary and Monitors
indication that it would take into account the final report of the Mid Staffordshire NHS
Foundation Trust Public Inquiry.
I would refer you to the official response of the Government on behalf of relevant
organisations including CQC and Monitor, Hard Truths: The Journey to Putting Patients
First, in particular recommendation 79 (which is attached to this letter). Amongst other
matters, the response to this recommendation which was accepted in principle indicates that
Monitors fit and proper persons requirement under its licence would remain and continue to
be enforced as intended when appropriate. Additional requirements for a wider fit and proper
persons test would be introduced through proposed regulations that would be the
responsibility of the CQC. That position has been implemented. As outlined in our letter of 23
December, this fit and proper persons test is applied by the CQC under the Health and
Social Care Act 2008 (Regulated Activities) Regulations 2014. As also outlined previously,
under our regulatory framework, Monitor can, does and will continue to take into account
relevant CQC judgments including those in relation to the fit and proper persons test.
4) Can Monitor give an undertaking that it will not in future admit managers who have
been found to have seriously harmed whistle-blowers to its interim pool?
As explained above, candidates are admitted to Monitors Interim Executive candidate pool
on the basis that they may have the potential to be suitable to perform interim executive
roles at following receipt of four relevant business references and case studies and
consideration of any relevant internal information demonstrating that they may have the
potential to be suitable to perform interim executive roles at NHS FTs.

Should the candidates be considered for any actual roles, their suitability will be considered
in detail at the appropriate stage by the NHS FT and on the basis of gathering any further
information and making any further necessary inquiries.
More broadly and in conclusion, I would like to reiterate that Monitor takes whistleblowing
issues extremely seriously. Our regulatory framework expressly enables us to consider
information from whistleblowers about organisations that we regulate and we have a central
team that has dedicated responsibility for liaising with whistleblowers who wish to contact us.
In addition, we are involved in a range of system-wide initiatives to support whistleblowers to
raise concerns, such as the recent formulation and promotion of a national whistleblowing
policy for providers of NHS services.

Yours sincerely,

Mark Turner
Regional Director, London Region